Population-based evaluation of second-line palliative chemotherapy (SCT) versus erlotinib (E) in advanced non-small cell lung cancer (NSCLC) patients (pts).
Bibliographic record
Abstract
e19080 Background: Several SCT options improve overall survival (OS) in advanced NSCLC. Recent evidence questions efficacy of E in EGFR wild type (WT) pts. Our objective was to evaluate the clinical effectiveness of SCT versus E in a diverse community population. Methods: The British Columbia Cancer Agency (BCCA) provides comprehensive cancer care to a population of 4.5 million. A retrospective analysis of all referred pts with stage 3b/4 NSCLC diagnosed in BC in 2009 who received SCT was performed. Kaplan-meier method with log-rank and Cox-proportional hazards model was used for survival analyses. Results: Of 748 pts seen by medical oncology, 415 (55%) had first-line CT, and 187 (25%) received SCT. Of these 107 (57%) received E, 55 (29%) pemetrexed (P), 11 (6%) docetaxel (D), 8 (4%) vinorelbine (V), 5 (3%) platinum-doublet, 1 an investigational drug. EGFR status was known in 44%. E treated pts were older, with a worse ECOG, and less third-line CT than SCT (P,V,D). PFS was longer in E than SCT at 2.3 mos (CI 1.2-3.4), and 2.1 mos (CI 1.5-2.7), p=0.01. OS was similar in the E and SCT at 8.2 mos (CI 6.9-9.4), and 6.8 mos (CI 3.9-9.7) respectively, p=0.203. Controlling for age and ECOG, the PFS HR was 1.00 (CI 0.44-2.3), p=0.99; and the OS HR was 1.04 (CI 0.41-2.6) for E treated pts. In the subgroup of EGFR WT pts, mPFS and mOS were statistically similar in E and SCT gps (Table). Conclusions: Although a higher proportion of pts who received E were older, poorer ECOG and had less subsequent CT, PFS and OS were similar to SCT pts. The effectiveness of E versus SLC will be evaluated in a larger cohort of pts. E (n=107) SCT (n=74) P value Sex Male 51 44 0.08 Female 56 30 Age, range 67, 44-80 63, 46-76 0.04 ECOG PS 0-2 62 54 0.03 3-4 45 20 Geographical site Rural 19 10 0.37 Urban 88 63 Unknown 0 1 Histology Non-squamous 79 52 0.45 Squamous 16 9 Not otherwise specified 12 13 EGFR WT 18 13 0.96 Mutated 1 1 Unknown 69 60 CT Third-line Fourth-line Fifth-line 36 8 2 45 6 3 <0.0001 0.88 0.41 Number cycles Third-line Fourth-line Fifth-line 3 1.5 2 2 2 1 0.82 0.90 0.50 Entire cohort, mos (95% CI) mPFS mOS 2.3 (1.2-3.4) 8.2 (7.0-9.4) 2.1 (1.4-2.7) 6.8 (4.3-9.3) 0.01 0.20 EGFR WT subgroup mPFS mOS 1.4 (1.9-3.3) 4.7 (3.5-6.9) 2.6 (1.9-3.2) 5.5 (2.8-8.2) 0.86 0.65
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".